Tissue ablation system including guidewire with sensing element

• US 20060135953A1
• Filed: 12/22/2004
• Published: 06/22/2006
• Est. Priority Date: 12/22/2004
• Status: Abandoned Application

• Current Assignee: Medtronic CryoCath LP (Medtronic Plc)
• Original Assignee: Medtronic CryoCath LP (Medtronic Plc)
• Inventors: Carroll, Sean, Skanes, Allan, Lane, Miriam, Kania, Wlodzimierz
• Application Number:
  US11/021,113
• Publication Number:
  US 20060135953A1
• Time in Patent Office: Days
• US Class Current: 606/21
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00044 Sensing electrocardiography, i.e. ECG
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 5/6851 Guide wires
• CPC Class Codes: A61B 5/6856 with a distal loop

Abstract

A tissue ablation system for ablating human tissue wherein sensing and ablation procedures are performed and controlled independently. A sensing wire is positioned distally to the ablation region and is adapted to pass thorough the ablation device such that it may move with or independently of the ablation device without obstructing the surface tissue interface of the ablation energy. The ablation device can ablate a substantial portion of a circumferential region of tissue, for example at or near the location where the pulmonary vein extends from the atrium. The tissue ablation system comprises an ablation device comprised of an elongated catheter with a proximal region and a distal region and an ablation element located proximate the distal region of the catheter. A sensing device having an elongated body with a proximal portion and a distal portion is adapted to be positioned within a vessel at or near a vessel ostium, wherein the sensing device is adapted to be slidably received within a lumen of the ablation device. The sensing device, a guide wire for example, may be shaped in various configurations to allow sensing device such as electrodes disposed thereon to contact the vessel wall near the ablation region. In this fashion, the sensing and ablation procedures are de-coupled such that the sensing device does not interfere or obstruct the ablation member'"'"'s interface with the tissue.

Claims

1. A medical device having a sensor and a device body, wherein the sensor is movable with respect to the device body.

2. The medical device of claim 1 wherein the device body is a treatment element.

3. The medical device of claim 2 wherein the treatment element is a probe.

4. The medical device of claim 2 wherein the treatment element is a catheter.

5. The medical device of claim 4 wherein the catheter is a balloon-catheter.

6. The medical device of claim 1 wherein the sensor is an electrocardiogram sensor.

7. The medical device of claim 1 wherein the sensor is an electrical sensor.

8. The medical device of claim 1 wherein the sensor detects impedence.

9. The medical device of claim 1 wherein the sensor detects pressure.

10. The medical device of claim 1 wherein the sensor detects temperature.

11. The medical device of claim 1 wherein the sensor detects two or more parameters selected from the group consisting of temperature, pressure, impedence, and electricity.

12. A tissue ablation system for ablating a region of tissue, the system comprising:

a treatment device having a proximal region and a distal region and a treatment element located proximate the distal region of the treatment device; and

a sensing device having a body with a proximal portion and a distal portion, the sensing device adapted to be positioned within a vessel, wherein the sensing device is adapted to be slidably received within a lumen of the treatment device.

13. The tissue ablation system of claim 12 wherein the treatment element is selected from the group consisting of a microwave ablation element, cryogenic ablation element, thermal ablation element, light-emitting ablation element, RF ablation element, ultrasound transducer, and substance delivery element.

14. The tissue ablation system of claim 12 where the treatment device is comprised of an elongated catheter with a proximal region and a distal region and an ablation element located proximate the distal region of the catheter.

15. The tissue ablation system of claim 12 where the sensing device is positioned distal to the treatment element.

16. The tissue ablation system of claim 12 where the treatment element is adjustable between a radially collapsed configuration and a radially expanded configuration.

17. The tissue ablation system of claim 16 where the treatment element includes one or more inflatable balloons.

18. The tissue ablation system of claim 12 wherein the treatment element engages the tissue at or near a vessel ostium.

19. The tissue ablation system of claim 18 wherein the treatment element maintains engagement with the tissue when the sensing device is slidably received within the lumen of the treatment device.

20. The tissue ablation system of claim 17 where the treatment element is pre-shaped to circumferentially engage the tissue at or near the vessel ostium.

21. The tissue ablation system of claim 18 where the treatment element is deflected to circumferentially engage the tissue at or near the vessel ostium.

22. The tissue ablation system of claim 12 where the sensing device is comprised of one or more electrodes.

23. The tissue ablation system of claim 12 wherein the distal portion of the sensing device is adjustable from a collapsed state to an expanded position to radially engage a wall of the vessel.

24. The tissue ablation system of claim 23 wherein the adjustable distal portion allows the sensing device to contact the tissue.

25. The tissue ablation system of claim 12 wherein the sensing device forms a circumferential shape.

26. The tissue ablation system of claim 25 wherein the circumferential shape is achieved by activating a pull wire.

27. The tissue ablation system of claim 25 wherein the circumferential shape is achieved by inserting a pre-shaped inner member within the sensing device.

28. The tissue ablation system of claim 27 wherein the pre-shaped inner member is comprised of shape memory material.

29. The tissue ablation system of claim 25 where the circumferential shape is achieved by removal of a stylet.

30. The tissue ablation system of claim 12 wherein the lumen of the treatment device is a guidewire lumen.

31. The tissue ablation system of claim 12 wherein the elongated body of the sensing device has an outer diameter of approximately 0.014 to 0.042 inches.

32. The tissue ablation system of claim 12 wherein the treatment device is in the shape of a loop and the sensing device passes through the loop'"'"'s interior.

33. The tissue ablation system of claim 12 wherein the system requires only a single transceptal puncture.

34. The tissue ablation system of claim 12 wherein the sensing device measures pressure.

35. The tissue ablation system of claim 12 wherein the sensing device is an electrocardiogram sensor.

36. The tissue ablation system of claim 12 wherein the sensing device detects impedence.

37. A tissue ablation system for ablating a region of tissue, the system comprising:

an ablation device comprised of an elongated catheter with a proximal region and a distal region and an ablation element located proximate the distal region of the catheter; and

a sensing device having an elongated body with a proximal portion and a distal portion, the sensing device adapted to be positioned within a vessel or at or near a vessel ostium, wherein the sensing device is adapted to be slidably received within a lumen of the ablation device, wherein the sensing device is adapted to slidably track side by side with the ablation device through a sheath such that the ablation element maintains engagement with the tissue when the sensing device is slidably received within the lumen of the ablation device.

38. The tissue ablation system of claim 37 where the sensing device is positioned distal to the ablation element.

39. The tissue ablation system of claim 37 where the ablation device is pre-shaped to circumferentially engage the tissue at or near the vessel ostium.

40. The tissue ablation system of claim 39 wherein the ablation device is pre-shaped using shape memory materials.

41. The tissue ablation system of claim 37 where the ablation device is deflected to circumferentially engage the tissue at or near the vessel ostium.

42. The tissue ablation system of claim 37 wherein the ablation device is in the shape of a loop and the sensing device passes through the loop'"'"'s interior.

43. The tissue ablation system of claim 37 wherein the distal portion of the sensing device is adjustable from a collapsed state to an expanded state to radially engage a wall of the vessel.

44. The tissue ablation system of claim 43 wherein the adjustable distal portion allows the sensing device to contact the tissue.

45. The tissue ablation system of claim 37 where the sensing device is comprised of one or more electrodes.

46. The tissue ablation system of claim 37 wherein the sensing device forms a circumferential shape.

47. The tissue ablation system of claim 46 wherein the circumferential shape is achieved by activating a pull wire.

48. The tissue ablation system of claim 46 wherein the circumferential shape is achieved by inserting a pre-shaped inner member within the sensing device.

49. The tissue ablation system of claim 48 wherein the pre-shaped inner member is comprised of shape memory material.

50. The tissue ablation system of claim 46 where the circumferential shape is achieved by removal of a stylet.

51. The tissue ablation system of claim 37 wherein the system requires only a single transceptal puncture.

52. The tissue ablation system of claim 37 wherein the lumen of the ablation device has a proximal port and a distal port, the proximal port being proximal to the ablation device and the distal port being distal to the ablation device.

53. The tissue ablation system of claim 37 wherein the elongated body has an outer diameter of approximately 0.014 to 0.042 inches.

54. The tissue ablation system of claim 37 wherein the sensor is an electrical sensor.

55. The tissue ablation system of claim 37 wherein the sensor is an electrocardiogram sensor.

56. The tissue ablation system of claim 37 wherein the sensing device measures pressure.

57. The tissue ablation system of claim 37 wherein the sensing device measures temperature.

58. The tissue ablation system of claim 37 wherein the sensing device measures impedence.

59. The tissue ablation system of claim 37 wherein the ablation element is selected from the group consisting of a microwave ablation element, cryogenic ablation element, thermal ablation element, light-emitting ablation element, RF ablation element, ultrasound transducer, and substance delivery element.

61. A sensing device having an elongated body with a proximal end portion and a distal end portion, the elongated body adapted to be positioned within a vessel and positionable through another device.

62. The sensing device of claim 61 wherein the distal end portion is adjustable from a collapsed position to an expanded position to radially engage a wall of the vessel.

63. The sensing device of claim 61 wherein the adjustable distal portion allows the sensing device to contact the tissue.

64. The sensing device of claim 61 wherein the sensing device is comprised of one or more electrodes.

65. The sensing device of claim 61 wherein the sensing device forms a circumferential shape.

66. The sensing device of claim 65 wherein the circumferential shape is achieved by actuating a pull-wire.

67. The sensing device of claim 65 wherein the circumferential shape is achieved by inserting a pre-shaped inner member within the sensing device.

68. The sensing device of claim 67 wherein the pre-shaped inner member is comprised of shape memory material.

69. The sensing device of claim 65 where the circumferential shape is achieved by removal of a stylet.

70. The sensing device of claim 65 wherein the elongated body has an outer diameter of approximately 0.014 to 0.042 inches.

71. The sensing device of claim 61 wherein the sensing device measures pressure.

72. The sensing device of claim 61 wherein the sensing device measures temperature.

73. The sensing device of claim 61 wherein the sensing device measures impedence.

74. The sensing device of claim 61 wherein the sensing device is an electrical sensor.

75. The sensing device of claim 61 wherein the sensing device is an electrocardiogram sensor.

76. A method of independently positioning a sensor with respect to an ablation element wherein the sensor and ablation element are part of a single device.

77. A tissue treatment system for treating a region of tissue, the system comprising:

a treatment device comprised of an elongated catheter with a proximal region and a distal region and a treatment element located proximate the distal region of the catheter; and

a sensing device adapted to be positioned within a vessel or at or near a vessel opening, wherein the sensing device is adapted to be slidably received within a lumen of the treatment device, wherein the sensing device is adapted to slidably track side by side with the treatment device through a sheath such that the treatment element maintains engagement with the tissue when the sensing device is slidably received within the lumen of the treatment device.